Toolkit for people who have been impacted

Toolkit for people who have been impacted by a suicide loss

Acknowledgments

The development of this document was made possible through the input, feedback and guidance of the Canadian Association for Suicide Prevention, the Centre for Suicide Prevention, the Public Health Agency of Canada and people with lived experience related to suicide.

THIS DOCUMENT WAS INFORMED/DEVELOPED BY:

Advisory Committee members:

1. Ally Campbell 2. Amanee Elchehimi 3. Andrea Rowe 4. Austin Mardon

5. Chris Summerville 6. John Dick 7. Katherine Tapley 8. Melynda Ehaloak

Working Group members: 1. Rebecca Sanford 2. Robert Olson 3. Jodie Golden 4. Yvonne Bergmans

Generously volunteering their time to add value, experience and rigor to the Toolkit, The Mental Health Commission of Canada is grateful for their contributions in the development of this project.

Toolkit for people who have been impacted by a suicide loss Mental Health Commission of Canada, 2018

The views in this document do not necessarily reflect the views of the MHCC.

Ce document est disponible en fran?ais

This document is available at Production of this document is made possible through a financial contribution from Health Canada.

Contents

Introduction

About the toolkit.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Strategies and coping suggestions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Strategies to help cope with a death by suicide.. . . . . . . . . . . . . . . . . . . . . . . 5 Following a suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Grief and suicide. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Resources for people with lived experience. . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Peer support groups. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Counselling. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Addiction services.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Coping suggestions and crisis planning. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Crisis lines.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Coping strategies and developing a safety plan.. . . . . . . . . . . . . . . . . . . . . . . . 8 Phone applications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Suggested messages when contacting a suicide crisis line. . . . . . . . . . . . . . 9 References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

How to support someone who has lost someone to suicide . . . . . . . . 11 How to talk about suicide in an honest, safe and age-appropriate way. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

Telling your story safely. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

Advocacy and finding hope through stories of suicide loss.. . . . . . . . . . . 13 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

Hopeful messages .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

For people living with a suicide loss .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Share your own message!. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

About suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

Background and context. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 What is suicide?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Basic statistics on suicide in Canada. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Safe language around suicide.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Myths and facts about suicide.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

Why do people attempt to die by suicide?. . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Social determinants of health. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Risk and protective factors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Warning signs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 The role of trauma and childhood experiences. . . . . . . . . . . . . . . . . . . . . . . . 20 References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

Additional resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

Training and other suicide prevention programs. . . . . . . . . . . . . . . . . . . . . . 22 Books, directories, editorials, academic studies. . . . . . . . . . . . . . . . . . . . . . . 23

Introduction

About the toolkit designed for people with lived experience related to a suicide loss.

What it is

The Mental Health Commission of Canada, in collaboration with the Canadian Association for Suicide Prevention, the Centre for Suicide Prevention, the Public Health Agency of Canada, along with an Advisory Committee comprised of people with lived experience related to suicide, have developed toolkits to support people who have been impacted by suicide. One toolkit is tailored for people who have attempted suicide, and the other is focused on resources for people who have lost someone to suicide.

In the summer of 2017, we conducted an online survey to elicit feedback from people who have been affected by suicide. With over 1,000 responses, the feedback received helped us gain a better understanding of what topics, content areas, resources, and information were important to include in the toolkits.

The content

There is no right or wrong way to seek help. This toolkit is not designed to be an exhaustive list of the very wide variety of resources available across Canada for support. This toolkit is a summary of the tools that have resonated most with the hundreds of people who completed our online survey and resources from a literature review completed by the Centre for Suicide Prevention.

If you are not finding the tools and resources that resonate most with you, you may consider talking with someone. You may wish to connect with a trained volunteer by contacting your local distress centre or Kids Help Phone.

Language

Many respondents indicated a preference for "people-first" language as opposed to "survivorship language". For this reason, we sought to avoid this language within the toolkit. That said, survivorship language resonates with many and therefore, we included links to resources that use this language.

Please note that the toolkits are not intended to replace a conversation. If you or someone you know is experiencing distressing thoughts or thoughts of suicide, please contact your local distress centre or Kids Help Phone.

Back to Table of Contents

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Strategies and coping suggestions

There is no single way or "right" way to cope with a death by suicide. Everyone's relationship with the person who has died is different. This means the loss will affect people differently. The following strategies are suggestions that have resonated with the people who responded to our online survey and additional resources from a literature review. It is not intended to be an exhaustive list.

If you are not finding the tools and resources that resonate most with you, you could try talking about your options with a trained volunteer by contacting your local distress centre.

Strategies to help cope with a death by suicide

FOLLOWING A SUICIDE ? After a Suicide: A Practical and Personal Guide for Survivors by

the Canadian Association for Suicide Prevention, is a guide to both the practical and the personal matters that you may need to attend to following a death by suicide. ? What to do after a suicide webinar by the Centre for Suicide Prevention walks teachers through what to do after a student in the school has died by suicide. ? After a suicide: A toolkit for schools acknowledges that a school community can be deeply affected by a student suicide. ? A Manager's Guide to Suicide Postvention in the Workplace: 10 Action Steps for Dealing with the Aftermath of Suicide by Carson J. Spencer Foundation examines when a suicide occurs in a workplace and the proper way to respond. ? Helping Survivors of Suicide: What Can You Do? by the American Association of Suicidology. ? Writing an obituary by the Ontario Funeral Service Association and the Waterloo Region Suicide Prevention Council, is a helpful tool for someone bereaved by suicide. ? Chapter 4, "Practical matters" from Hope and healing after suicide, A practical guide for people who have lost someone to suicide in Ontario by the Centre for Addiction and Mental Health.

GRIEF AND SUICIDE

Many will suggest that bereavement after a suicide is unlike any other kind of bereavement. As the National Alliance for Suicide Prevention states" suicide bereavement is unique because suicide itself is a singular manner of death" (2015, p. 13). The standard grieving process is further complicated by the inexplicable nature of suicide itself. Add notions of guilt and the pressures of stigma and we can see potential risk for suicide for anyone experiencing complicated grief due to suicide.

? Reactions to a suicide loss will be different for every person. Some of these reactions may include: ?? Shock and numbness ?? Deep sadness ?? Anger and blame ?? Guilt ?? Shame ?? Relief ?? Denial ?? Why questions ?? Fear ?? Depression ?? Leaning on spiritual or religious beliefs ?? Thinking about suicide ?? Reaching out

Find out more about each one of these "Normal Reactions to Suicide Loss" by the Canadian Association for Suicide Prevention.

? What is grief by the Canadian Mental Health Association.

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